the beleaguered NHS<\/a> and has a brogue that I can only just decipher; I am impressed that my mum understood his first two questions.<\/p>\n\u201cAre you in transit from an international destination?\u201d<\/p>\n
The big words are lost in enunciation.<\/p>\n
\u201cHow about pressure sores?\u201d<\/p>\n
She looks at him quizzically; he tries to explain. It\u2019s painful: the questioning, not the sores. Most patients are not aware of developing pressure sores. The ones who suffer from them are typically emaciated.<\/p>\n
\u201cNo,\u201d I reply before explaining in Hindi how pressure sores develop. She shudders.<\/p>\n
\u201cDo you use a gait aid?\u201d<\/p>\n
I translate and let her answer, the more to empower her for the future.<\/p>\n
\u201cAre you cognitively impaired?\u201d<\/p>\n
I consider the irony of this question and the singular unreliability of a response. Cognitively impaired patients would deny this or not know how to answer and the well ones might be offended.<\/p>\n
There is no easy Hindi translation; before I say more, the nurse helpfully adds, \u201clike dementia\u201d.<\/p>\n
Her expression clouds.<\/p>\n
\u201cDo you have dietary restrictions?\u201d<\/p>\n
\u201cHe is asking what you don\u2019t eat.\u201d<\/p>\n
\u201cBeef and pork.\u201d<\/p>\n
\u201cAre you on a fluid restriction?\u201d<\/p>\n
\u201cI just don\u2019t eat beef and pork.\u201d<\/p>\n
The questions keep coming. My mum nods and smiles, confident that if something really matters, I will step in.<\/p>\n
By now, I am wondering how other patients faithfully answer these questions filled with jargon and some even unintentionally discomfiting. How many anxious people simply nod along, trusting the staff know what they are doing?<\/p>\n
I wouldn\u2019t rely on a cognitively impaired patient to provide the details that would help me provide better care \u2013 being vigilant about the risk of delirium and falls, for instance. It is the uncommon patient who knows the date of their last blood test, every dose of every medication and the precise indication for every procedure.<\/p>\n
As the nurse continues, all I can think is: who writes these questions and who vets them? How can we know that this is time well spent on patient care? Is there a box saying that the patient did not (seem to) understand? Or one saying that an interpreter was required but not provided? (Large public hospitals typically provide access; private hospitals bypass the very expectation.)<\/p>\n
Her doctor is calm and confident, but his reassurance is marred by the next entrant, dressed in a black cassock and purple Roman collar.<\/p>\n
The priest\u2019s eyes flick between my mother and me. He has probably been called to administer last rites and looks confused.<\/p>\n
\u201cAre you Joan, or is she Joan?\u201d<\/p>\n
\u201cNeither of us looks like a Joan,\u201d I smile, prompting him to flee.<\/p>\n
I am guffawing when I hear my mum concerned.<\/p>\n
\u201cWhy did the doctor send a priest?\u201d<\/p>\n
\u201cIt wasn\u2019t for you.\u201d<\/p>\n
\u2018Are you sure?\u2019<\/p>\n
It\u2019s a scene dying for a comedy scriptwriter.<\/p>\n
To do something nice, I call the kitchen and order jelly, one of two things she is allowed.<\/p>\n
\u201cShe can\u2019t have it,\u201d the chef rules. \u201cJelly contains gelatin and your mum is allergic to beef and pork.\u201d<\/p>\n
\u201cShe is not allergic; she is Hindu!\u201d I protest. \u201cAnd she eats jelly.\u201d<\/p>\n
But my protests fall on closed ears.<\/p>\n
\u201cThe allergy label has to go first.\u201d<\/p>\n
I hang up, bursting with laughter but also sympathetic to the strain it places on patients and relatives to settle inane issues amongst important ones.<\/p>\n
Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use only the good passport, sooner or later each of us is obliged, a least for a spell, to identify ourselves as citizens of that other place.<\/p>\n
Susan Sontag\u2019s words, written in 1978 during her cancer diagnosis, remain as meaningful then as now, in an era of unprecedented gains in medical technology and treatment but not necessarily in the way we communicate with patients.<\/p>\n
My mother\u2019s experience has given me renewed empathy for patients and their caregivers. While we are busy documenting their needs, we are not actually meeting their needs. From visible symptoms to unspoken suffering, from cultural preferences to deeply personal choices \u2013 there is a lot healthcare providers need to know but only if our head is not buried in the paperwork. True patient-centred care takes more than a checklist.<\/p>\n
It takes the nurse on the next shift time to understand the issue, re-enter the computer system and delete the allergy. A triumphant chef delivers the jelly. I feel bad knowing that the nurse had more fruitful tasks at hand.<\/p>\n
Australia performs very well<\/a> in the world in important healthcare metrics.<\/p>\nWe must not rest on our laurels \u2013 and continue to strive for patient-centred care, which includes stopping doing things because \u2018they have always been done that way.\u2019<\/p>\n
Ranjana Srivastava is an Australian oncologist, award-winning author and Fulbright scholar. Her latest book is Every Word Matters: Writing to Engage the Public<\/p>\n","protected":false},"excerpt":{"rendered":"\u201cAre you anxious?\u201d \u201cA little bit.\u201d \u201cWhat medications do you take?\u201d The neatly packed transparent plastic bag is…\n","protected":false},"author":2,"featured_media":215770,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[43],"tags":[102,2960,56,54,55],"class_list":{"0":"post-215769","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-healthcare","8":"tag-health","9":"tag-healthcare","10":"tag-uk","11":"tag-united-kingdom","12":"tag-unitedkingdom"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/215769","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/comments?post=215769"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/215769\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media\/215770"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media?parent=215769"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/categories?post=215769"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/tags?post=215769"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}